Risk stratification of COVID-19 patients is essential for pandemic management. Changes in the cell fitness marker, hFwe-Lose, can precede the host immune response to infection, potentially making such a biomarker an earlier triage tool. Here, we evaluate whether hFwe-Lose gene expression can outperform conventional methods in predicting outcomes (e.g., death and hospitalization) in COVID-19 patients. We performed a post-mortem examination of infected lung tissue in deceased COVID-19 patients to determine hFwe-Lose’s biological role in acute lung injury. We then performed an observational study (n = 283) to evaluate whether hFwe-Lose expression (in nasopharyngeal samples) could accurately predict hospitalization or death in COVID-19 patients. In COVID-19 patients with acute lung injury, hFwe-Lose is highly expressed in the lower respiratory tract and is co-localized to areas of cell death. In patients presenting in the early phase of COVID-19 illness, hFwe-Lose expression accurately predicts subsequent hospitalization or death with positive predictive values of 87.8–100% and a negative predictive value of 64.1–93.2%. hFwe-Lose outperforms conventional inflammatory biomarkers and patient age and comorbidities, with an area under the receiver operating characteristic curve (AUROC) 0.93–0.97 in predicting hospitalization/death. Specifically, this is significantly higher than the prognostic value of combining biomarkers (serum ferritin, D-dimer, C-reactive protein, and neutrophil–lymphocyte ratio), patient age and comorbidities (AUROC of 0.67–0.92). The cell fitness marker, hFwe-Lose, accurately predicts outcomes in COVID-19 patients. This finding demonstrates how tissue fitness pathways dictate the response to infection and disease and their utility in managing the current COVID-19 pandemic.

中文翻译：

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Flower loss是一种细胞健康标记，可以预测COVID-19的预后

COVID-19 患者的风险分层对于大流行管理至关重要。细胞适应性标记hFwe-Lose的变化可以先于宿主对感染的免疫反应，从而可能使此类生物标记成为早期分类工具。在这里，我们评估hFwe-Lose基因表达在预测 COVID-19 患者的结局（例如死亡和住院）方面是否优于传统方法。我们对已故的 COVID-19 患者的受感染肺组织进行了尸检，以确定hFwe-Lose在急性肺损伤中的生物学作用。然后，我们进行了一项观察性研究（n  = 283），以评估hFwe-Lose表达（在鼻咽样本中）是否可以准确预测 COVID-19 患者的住院或死亡。在患有急性肺损伤的 COVID-19 患者中，hFwe-Lose在下呼吸道中高表达，并且共定位于细胞死亡区域。在 COVID-19 疾病早期的患者中，hFwe-Lose表达可以准确预测随后的住院或死亡，阳性预测值为 87.8-100%，阴性预测值为 64.1-93.2%。hFwe-Lose优于传统炎症生物标志物、患者年龄和合并症，在预测住院/死亡方面，受试者工作特征曲线下面积 (AUROC) 为 0.93-0.97。具体而言，这显着高于结合生物标志物（血清铁蛋白、D-二聚体、C-反应蛋白和中性粒细胞-淋巴细胞比率）、患者年龄和合并症（AUROC 为 0.67-0.92）的预后价值。细胞健康标记hFwe-Lose可以准确预测 COVID-19 患者的结果。这一发现证明了组织健康途径如何决定对感染和疾病的反应及其在管理当前 COVID-19 大流行中的效用。